title: Increase of caffeine and decrease of corticosteroids for extremely low-birthweight infants with respiratory failure from 1997 to 2011.
abstract: OBJECTIVE
  To compare treatment strategies for respiratory failure in extremely low-birthweight (ELBW) infants in Germany in 1997 to Germany, Austria and Switzerland in 2011.
  
  
  METHODS
  A detailed questionnaire about treatment strategies for ELBW infants was sent to all German centres treating ELBW infants in 1997. A follow-up survey was conducted in 2011 in Germany, Austria and Switzerland.
  
  
  RESULTS
  In 1997 and 2011, 63.6% and 66.2% of the hospitals responded. In 2011, the response rate was higher in Switzerland than in Germany, and in university hospitals versus nonuniversity hospitals. Treatment strategies did not differ between university and nonuniversity hospitals as well as NICUs of different sizes in 2011. Differences between Germany, Austria and Switzerland were minimal. Administration of caffeine increased significantly, whereas theophylline and doxapram declined (all p < 0.001). While the use of dexamethasone decreased and the use of hydrocortisone increased, the overall use of corticosteroids declined (all p < 0.001). Between 1997 and 2011, therapy with inhalations and mucolytics decreased (both p < 0.001), whereas the use application of diuretics did not change significantly. In mechanically ventilated infants, the application of muscle relaxants and sedation declined significantly (p = 0.009 and p < 0.001), whereas analgesia use did not change.
  
  
  CONCLUSIONS
  Treatment strategies for respiratory failure in ELBW infants have changed significantly between 1997 and 2011.
authors.affiliation: Division of Neonatology, University Children's Hospital Inselspital Berne, Berne, Switzerland. roland.gerull@insel.ch.
authors.forename: Roland
authors.initials: R
authors.lastname: Gerull
authors.forename: Helen
authors.initials: H
authors.lastname: Manser
authors.forename: Helmut
authors.initials: H
authors.lastname: Küster
authors.forename: Tina
authors.initials: T
authors.lastname: Arenz
authors.forename: Mathias
authors.initials: M
authors.lastname: Nelle
authors.forename: Stephan
authors.initials: S
authors.lastname: Arenz
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D001997:Bronchopulmonary Dysplasia / Q000628:therapy; D002110:Caffeine / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D010372:Pediatrics / Q000639:trends; D012131:Respiratory Insufficiency / Q000628:therapy*
chemical_list: D000305:Adrenal Cortex Hormones; D000697:Central Nervous System Stimulants; D002110:Caffeine
keywords: Caffeine; Corticosteroids; Extremely low-birthweight infants; Preterm infants; Respiratory failure; Survey